Development of support material for health professionals who are implementing Shared Decision-making in breast cancer screening: validation using the Delphi technique

Background The Literature is no report support material on Shared Decision-making applied to breast cancer screening that is intended for Spanish health professionals. The researcher created both a handbook and a guide for this topic using an adaption of the Three-talk model. Objective A Delphi method will be used to reach an agreement among experts on the contents and design of a manual and guide, designed by the research team, and to be used by health professionals in the application of SDM in breast cancer screening. Design A qualitative study. The content and design of the handbook and the guide was discussed by 20 experts. The Delphi techniques was in an online mode between July and October 2020 and researchers used Google forms in three rounds with open and closed questions. The criterion established for consensus was a coefficient of concordance (Cc) above 75, for questions using a Likert scale of 1-6-in which 1 meant 'completely disagree' and 6 'completely agree'-with a cut-off point equal to or higher than 4. Results Participants considered the Three-talk model suitable for the screening context. The handbook sections and level of detail were considered satisfactory (Cc=90). The summary provided by the clinical practice guide was considered necessary (Cc=75), as it was the self-assessment tool for professionals (Cc=85). Content was added: addressing the limitations of the SDM model; extending the number of sample dialogues for health professionals; providing supplementary resources on using Patient Decisions aids and adding references on communication skills. Conclusions and applications The first handbook and clinical practice guide providing unique SDM support material for health professionals have been developed. The handbook and guide are useful and innovative as supporting material for health professionals, but training strategies for SDM and a piloting plan for the use of materials are requested, in order to facilitate its implementation

Women’s preference to apply shared decision-making in breast cancer screening: a discrete choice experiment

ObjectiveTo analyse women's stated preferences for establishing the relative importance of each attribute of shared decision-making (SDM) and their willingness to pay (WTP) for more participatory care in breast cancer screening programmes (BCSP). DesignA discrete choice experiment was designed with 12 questions (choice tasks). It included three attributes: 'How the information is obtained', regarding benefits and harms; whether there is a 'Dialogue for scheduled mammography' between the healthcare professional and the woman; and, 'Who makes the decision', regarding participation in BCSP. Data were obtained using a survey that included 12 choice tasks, 1 question on WTP and 7 socioeconomic-related questions. The analysis was performed using conditional mixed-effect logit regression and stratification according to WTP. SettingData collection related to BCSP was conducted between June and November 2021 in Catalonia, Spain. ParticipantsSixty-five women aged between 50 and 60. Main outcome measuresWomen's perceived utility of each attribute, trade-off on these attributes and WTP for SDM in BCSP. ResultThe only significant attribute was 'Who makes the decision'. The decision made alone (coefficient=2.879; 95% CI=2.297 to 3.461) and the decision made together with a healthcare professional (2.375; 95% CI=1.573 to 3.177) were the options preferred by women. The former contributes 21% more utility than the latter. Moreover, 52.3% of the women stated a WTP of Euro10 or more for SDM. Women's preferences regarding attributes did not influence their WTP.ConclusionsThe participant women refused a current paternalistic model and preferred either SDM or informed decision-making in BCSP

Impact of a topical anaesthesia wound management formulation on pain, inflammation and reduction of secondary infections after tail docking in lambs

We examined several procedures for surgical tail docking; with and without general anaesthesia (GA), including the use of a topical wound gel formulation to provide pain relief (PR) and improve healing after surgery, containing local anaesthetics lignocaine and bupivacaine, with cetrimide and adrenalin. Forty-four lambs were recruited into four equal cohorts: Groups A and C, the tail was excised with a scalpel without anaesthesia or stitches; Groups B and D, the tail was surgically excised and stitched under GA; Groups C and D wounds were immediately sprayed with PR. Behavioural observations identified that Groups A and C displayed significantly less pain-related behaviours than Groups B and D shortly after the procedure, especially if treated with PR. Similarly, the mean of days when animals showed no signs of wound infection was longer in the groups not undergoing stitching. Finally, treatment with PR appeared to reduce the cortisol response and avoided the elevation of serum amyloid A in lambs where the tail was excised without general anaesthesia. In conclusion, surgical tail-docking without GA but where wounds are immediately sprayed with PR, appears as an affordable and more welfare-appropriate method for conducting tail docking in lambs

Evolución de la mortalidad por cáncer de mama y diseminación de la mamografía de cribado en Cataluña: un análisis por regiones sanitarias

Fundamento: El descenso de las tasas de mortalidad por cáncer de mama (CM) se ha atribuido a la implantación de programas de cribado y a avances terapéuticos. El objetivo de este trabajo es comparar la evolución de su mortalidad en las regiones sanitarias de Cataluña en el periodo 1993-2007. Paralelamente, se ha analizado la diseminación de la mamografía periódica en las regiones sanitarias. Métodos: Se analizaron los datos del registro de mortalidad y encuestas de salud. Se utilizaron regresiones de Poisson y «joinpoint» para comparar las tasas de mortalidad por CM y analizar su evolución temporal. Se utilizaron modelos de efectos mixtos para comparar el nivel y la evolución de la mortalidad por regiones. Resultados. La tasa de mortalidad por CM descendió un 3% anual en Cataluña. Entre 1993 y 2007, la tasa estandarizada varió de 34,8 a 23,3 por 100.000 mujeres. Barcelona ciutat presentó unas tasas de mortalidad más elevadas que las regiones Centre (ratio de tasas (RT)=0,87), Costa de Ponent (RT=0,89), Tarragona (RT=0,9) y Lleida (RT=0,915), pero estas diferencias tendieron a desaparecer. No se observaron cambios de tendencia en la evolución de la mortalidad de las regiones, excepto en la región Centre. Durante los años 1990 Barcelona ciutat presentó unos porcentajes de utilización de mamografía periódica del 36,1% de las mujeres de 40-74 años, en la encuesta de 1994, la región Centre (23,7%) y Costa de Ponent (25,2%). Conclusiones: La progresiva utilización de mamografía periódica y la disminución de la mortalidad por CM fueron similares en las regiones sanitarias de Cataluña.Background: The decrease of breast cancer (BC) mortality rates has been attributed to early detection programs and therapeutic advances. The objective is to compare BC mortality trend in health regions of Catalonia during the period 1993-2007. In parallel, dissemination of periodic mammography in the health regions has been analyzed. Methods: Mortality and health surveys data were used. Poisson and «joinpoint» regression analyses were used to compare regional BC mortality rates and quantify their temporal evolution. Mixed effects models were used to compare the rates and their evolution by region. Results: The BC mortality rate decreased 3% annually in Cataluña. Between 1993 and 2007, the standard mortality rate changed from 34.8 to 23.3 per 100,000 women. Barcelona ciutat showed higher mortality rates than the Centre (rate ratio (RR)=0.873), Costa de Ponent (RR=0.885), Tarragona (RR=0.9) and Lleida regions (RR=0.915), but these differences tend to disappear over time. There were no observed trend changes in the evolution of the regional mortality rates, except in the Centre region. The use of periodic mammography was similar across health regions. During the 90s, Barcelona ciutat had a 36.1% utilization of periodic mammography in women aged 40-74, in the 1994 survey, the Centre 23.7 and Costa de Ponent 25.2%. Conclusions: The progressive increase in the use of periodic mammography and the decrease of BC mortality were similar in the eight health regions of Catalonia

Towards a DNA-vaccine against African swine fever: an ongoing effort

Trabajo presentado en el 6th International Symposium on Emerging and Re-emerging pig Diseases, celebrado en Barcelona (España) del 12 al 15 de julio de 2011

Sars-cov-2 seroprevalence in household domestic ferrets (Mustela putorius furo)

Animal infections with SARS-CoV-2 have been reported in different countries and several animal species have been proven to be susceptible to infection with SARS-CoV-2 both naturally and by experimental infection. Moreover, infections under natural conditions in more than 20 mink farms have been reported where humans could have been the source of infection for minks. However, little information is available about the susceptibility of pet animals under natural conditions and currently there is no SARS-CoV-2 epidemiological assessment occurrence in household ferrets. In this study, the presence of SARS-CoV-2 antibodies was evaluated in serum samples obtained from 127 household ferrets (Mustela putorius furo) in the Province of Valencia (Spain). Two ferrets tested positive to SARS-CoV-2 (1.57%) by in-house enzyme-linked immunosorbent assay based on receptor binding domain (RBD) of Spike antigen. Furthermore, anti- RBD SARS-CoV-2 antibodies persisted at detectable levels in a seropositive SARS-CoV-2 domestic ferret beyond 129 days since the first time antibodies were detected. This study reports for the first time the evidence of household pet ferrets exposure to SARS-CoV-2 in Spain to date

Charged-particle multiplicities in pp interactions at root s=900 GeV measured with the ATLAS detector at the LHC

The first measurements from proton-proton collisions recorded with the ATLAS detector at the LHC are presented. Data were collected in December 2009 using a minimum-bias trigger during collisions at a centre-of-mass energy of 900 GeV. The charged-particle multiplicity, its dependence on transverse momentum and pseudorapidity, and the relationship between mean transverse momentum and charged-particle multiplicity are measured for events with at least one charged particle in the kinematic range |eta|500 MeV. The measurements are compared to Monte Carlo models of proton-proton collisions and to results from other experiments at the same centre-of-mass energy. The charged-particle multiplicity per event and unit of pseudorapidity at eta = 0 is measured to be 1.333 +/- 0.003 (stat.) +/- 0.040 (syst.), which is 5-15% higher than the Monte Carlo models predict